Commercial and Insurance

Insurance Disputes


How Insurance Companies Operate

When you buy insurance, you are buying “peace of mind.” At least that is what most of us think when we think of insurance, be it auto insurance, home insurance, life insurance, disability insurance, travel insurance, and so on. The reality is that while insurance companies sell “peace of mind”, their objective, like most companies, is to make money. They make money by selling this product and they make money by not paying for claims. The result is that many people who thought they had valid coverage find themselves having their claims denied or “investigated” for prolonged periods of time. Instead of getting protection, they get conflict, stress and sleepless nights. The question is: What can a person do when their claim is denied, or when they are told that their claim is “under investigation.”

Your Rights

It is important to understand that when you buy insurance, you are not buying “peace of mind.” What you are really buying is rights you can enforce against your insurer when they fail to provide you with the protection they sold you. In most instances, we do not need to sue. We often start off with a demand letter outlining the facts, the law, and our demand that the insurer comply with the terms of the contract. Insurers often know when they are wrong. The problem is that most people are vulnerable because they do not know the law, they do not know what information to give the insurer (or not to give), and they fail to recognize red flags during the claims process. Insurers knows this and, unfortunately, they sometimes take advantage of the situation.

Strict Time Limitations

There are strict time limitations for starting lawsuits against insurers. Most people are unaware of these timelines and often miss them. When you miss a limitation period, the insurer does not have to pay your claim and your right to sue them is taken away. People generally come to us for one of the following reasons:

  • Their claim is taking very long to resolve;
  • The adjuster on their file continues to ask for more and more informaton and documentation, some of which may seem irrelevant;
  • They are told that their file was transferred to SIU (Special Investigations Unit); or
  • Their claim has been denied.

All of these are red flags and if you experience any of these situations, you should immediately consult a lawyer.

 

 

Commercial and Insurance Team

Sivan Tumarkin

Sivan Tumarkin

Partner

James K. Fireman

James K. Fireman

Partner

Albert Klein

Albert Klein

Associate